10 Reasons Ultrasound Imaging beats MRI and Xray for Diagnosing and Treating Musculoskeletal Conditions


Musculoskeletal injuries from sports, trauma or overuse can be painful, messy and difficult to differentiate various layers and structures beneath the skin’s surface.

Ultrasound imaging can identify the exact location and nature of a musculoskeletal injury within seconds, enabling the health care provider to accurately diagnose and treat injured patients.

If you are not convinced that Ultrasonography is the best imaging technology for musculoskeletal injuries, here are 10 compelling reasons to become a believer.

  1. Universal Application: Radiation from Xrays and magnetic forces from MRI render the technologies inappropriate for certain patients, including pregnant mothers, and patients with pacemakers and metal implants. Ultrasound is safe for everyone, and is commonly used with pregnant mothers to view the fetus in utero.
  2. More Detail: Depending on the type of transducer used and the type of MRI, ultrasound can reveal more detail than MRI, which in turn offers more detail than an Xray.
  3. Real-Time Imaging: While MRI and Xray take only static shots, ultrasound imaging can be viewed by both clinician and patient in real time, meaning the clinician can see the underlying structures as the patient moves, confirming accurate diagnosis. Ultrasound can also be used therapeutically to retrain functional movement.
  4. Patient Feedback: During MRI and Xray, the patient is isolated from clinicians and instructed to not move. During ultrasound, the patient plays an active role in diagnosis, providing verbal feedback and altering position as needed.
  5. Medical Implants are Visible: During ultrasound, the clinician can distinguish implants and medical hardware that may be interfering with movement or causing pain. MRI is contraindicated for patients with implants.
  6. Doppler Imaging Aids Diagnosis: Ultrasound enables the clinician to detect changes in blood flow that can help pinpoint the injury and source of pain.
  7. Accuracy of Needle Procedures is Enhanced: When performed in conjunction with ultrasound, needle procedures can be accurately directed to a specific bursa, tendon, joint or other structure.
  8. Same-Day Observation of Bilateral Structures: MRI only enables imaging of one side of the body per session. Ultrasonography can be performed bilaterally in the same session, enabling clinicians to compare and contrast structural bodies.
  9. Entire Structures are Observable: Ultrasound enables clinicians to observe the entire length of structures like long muscles and nerves in real time. MRI only captures images of isolated body segments.
  10. Compactness and Portability: Xray and MRI equipment requires ample space, and cannot be moved. Ultrasound units are highly portable, enabling clinicians to the patient. This can be useful on the battlefield or in tragic emergency medical situations.

While ultrasound technology is a relative late-comer to the diagnostic table, it is rapidly gaining ground as a superior form of imaging for musculoskeletal injuries.

Musculoskeletal Ultrasound Imaging in NYC

For accurate diagnosis and treatment of musculoskeletal injuries and conditions, the sports medicine team at NYDNRehab relies on diagnostic ultrasonography and other technologies tom of your pain and heal it. Do not waste time on Xrays and MRI. Get accurate real-time imaging and treatment at NYDNRehab, so you can recover from your musculoskeletal injury and get back in the game.



In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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